HomeLatest NewsFederal NewsSenators Call for CMS to Increase MA Plan Oversight

Senators Call for CMS to Increase MA Plan Oversight

According to an article published by the American Hospital Association (AHA), the Centers for Medicare & Medicaid Services (CMS) should require Medicare Advantage (MA) plans to submit additional data and the agency should publicly release the MA data it already collects, a bipartisan group of senators told the agency last week. The letter requests a staff-level briefing by Dec. 27 on CMS’ plan to improve its data collection and reporting practices for MA plans.
“Without publicly available plan-level data on prior authorization requests by type of service, timeliness of determinations and reasons for denials; claims and payment requests denied after a service has been provided; beneficiary out-of-pocket spending; and disenrollment patterns, policymakers and regulators are unable to adequately oversee the program and legislate potential reforms,” wrote Sens. Elizabeth Warren, D-Mass.; Bill Cassidy, R-La.; Catherine Cortez Masto, D-Nev.; and Marsha Blackburn, R-Tenn.
AHA has urged CMS and the Department of Justice to hold Medicare Advantage plans accountable for inappropriately restricting beneficiary access to medically necessary care; and CMS to rigorously enforce changes included in the calendar year 2024 MA final rule to improve enrollee access and reduce administrative burden for providers and patients.

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